Provider Demographics
NPI:1821073669
Name:MACLEAN, LINDA GARRELTS (RPH, CDE)
Entity Type:Individual
Prefix:PROF
First Name:LINDA
Middle Name:GARRELTS
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:RPH, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-7100
Mailing Address - Country:US
Mailing Address - Phone:509-838-6451
Mailing Address - Fax:509-838-9787
Practice Address - Street 1:906 S MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3836
Practice Address - Country:US
Practice Address - Phone:509-838-6451
Practice Address - Fax:509-838-9787
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00010447183500000X
IL0051-034161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist